Background As the health systems around the world struggled to meet the challenges of COVID-19 pandemic, care of many non-COVID emergencies was affected. Aims The present study examined differences in the diagnosis, evaluation and management of stroke patients during a defined period in the ongoing pandemic in 2020 when compared to a similar epoch in year 2019. Methods The COVID stroke study group (CSSG) India, included 18 stroke centres spread across the country. Data was collected prospectively between February and July 2020 and retrospectively for the same period in 2019. Details of demographics, stroke evaluation, treatment, in-hospital and three months outcomes were collected and compared between these two time points. Results A total of 2549 patients were seen in both study periods; 1237 patients (48.53%) in 2019 and 1312 (51.47%) in 2020. Although the overall number of stroke patients and rates of thrombolysis were comparable, a significant decline was observed in the month of April 2020, during the initial period of the pandemic and lockdown. Endovascular treatment reduced significantly and longer door to needle and CT to needle times were observed in 2020. Although mortality was higher in 2020, proportion of patients with good outcome were similar in both the study periods. Conclusions Although stroke admissions and rates of thrombolysis were comparable, some work flow metrics were delayed, endovascular stroke treatment rates declined and mortality was higher during the pandemic study period. Reorganization of stroke treatment pathways during the pandemic has likely improved the stroke care delivery across the globe.

Intravenous Paracetamol is a centrally acting antipyretic and analgesic, has less gastrointestinal and platelet inhibiting side effects and is clinically better tolerated. IV Paracetamol could potentially provide adequate perioperative analgesia as a single agent for mild to moderate pain. Diclofenac a NSAID that mediate anti-inflammatory, analgesic and platelet inhibiting effects. NSAIDS are effective in peri operative setting for mild to moderate pain, but their usefulness may be limited due to their tendency to cause gastrointestinal and surgical site hemorrhage and renal failures in high risk patients. The present study conducted in 50 patients aged between 12-20 yrs who are scheduled for elective Tonsillectomy under general anesthesia in ENT hospital, Osmania Medical College, Hyderabad. To conclude that Paracetamol given every 6 th hourly parenterally can be used for intra operative and postoperative analgesia (mild to moderate pain) in elective Tonsillectomy in view of its good quality of analgesia, and its anti-pyretic effect.